23例持续性局灶性癫痫患儿的临床特点研究  

Clinical characteristics of 23 children with epilepsia partialis continua

作　　者：申文雯 王诗雨 李婷 张礼萍[1] SHEN Wenwen;WANG Shiyu;LI Ting(Department of Pediatrics,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院儿科,北京100053

出　　处：《中风与神经疾病杂志》2024年第9期811-815,共5页Journal of Apoplexy and Nervous Diseases

基　　金：首都医科大学宣武医院2022年度国自然青年培育项目(QNPY2022008)。

摘　　要：目的 提高对持续性局灶性癫痫、即持续性部分性癫痫(EPC)患儿临床表现的认识,为临床治疗及预后提供支持。方法 回顾性分析2017年7月—2022年7月于首都医科大学宣武医院儿科就诊的23例EPC患者资料。收集一般信息、临床表现、脑电图等诊断信息、手术及预后信息。结果 共收治23例患者,其中男15例、女8例,起病年龄(5.1±3.0)岁,癫痫暴露年龄(6.0±3.5)岁。21例(91.3%)患者以局灶起源运动性发作起病。11例(47.8%)于病程0.3~3年出现偏瘫。受检患者脑电图均呈现受累半球节律减慢,11例受检患者出现大脑半球萎缩,13例出现海马体异常。7例受检患者患侧大脑半球代谢均降低,9例受检患者均存在大脑不同区域血流灌注降低。10例进行手术,手术年龄(7.7±3.4)岁,手术时病程(3.6±3.6)年,术后7例无发作,2例病情缓解,1例手术无效。结论 EPC多发于学龄前期和学龄期儿童,所有患者脑电图存在受累半球节律减慢及发作间期的癫痫样放电。患者脑部血流灌注降低与其EPC发病可能存在相关性。手术治疗可有效改善EPC患者癫痫发作情况。Objective To study the clinical manifestations of children with epilepsia partialis continua(EPC),and to improve the understanding of the treatment and prognosis of this disease.Methods We retrospectively analyzed the data of 23 patients with EPC at the Department of Pediatrics of Xuanwu Hospital of Capital Medical University from July 2017 to July 2022.The data included general information,clinical manifestations,electroencephalography(EEG)re⁃sults,and surgical and prognostic information.Results A total of 23 patients(15 males and 8 females)were included,with a mean age of onset of(5.1±3.0)years and a mean age of epileptic exposure of(6.0±3.5)years.Twenty-one pa⁃tients(91.3%)developed motor seizures of focal origin as the initial presentation.Eleven patients(47.8%)presented with hemiparesis at 0.3 to 3 years after disease onset.All the patients showed a slow rhythm of the affected hemisphere on EEG;and cerebral hemiatrophy was found in 11 cases,and hippocampal abnormalities were found in 13 cases.The me⁃tabolism of the affected hemisphere was decreased in all the 7 examinees.All the 9 examinees had decreased perfusion in different brain regions.Among 10 cases undergoing surgery,the mean age at the time of the operation was(7.7±3.4)years,and the mean duration of the disease at the time of the operation was(3.6±3.6)years;after surgery,7 cases were free from seizures;2 cases had remission,and 1 had no improvement.Conclusion EPC is common in preschool-age and school-age children,manifesting as slower rhythms and interictal epileptiform discharges in the affected hemisphere on EEG.The decreased perfusion of the brain may be linked to the development of EPC.Surgical treatment can alleviate seizures for patients with EPC.

关 键 词：局灶性癫痫 持续性部分性癫痫 局灶性发作 脑电图 大脑半球传导纤维阻断术 

分 类 号：R742.1[医药卫生—神经病学与精神病学]